Organization Active NPI

Hadar H Waldman MD, a Professional Corporation

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
National Provider Identifier
1346607280
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
HADAR H WALDMAN MD, A PROFESSIONAL CORPORATION
Practice address
10309 Santa Monica Blvd # 300
Los Angeles, CA 90025-5007
Phone
(310) 556-1427
Fax
(310) 282-8567
NPI assigned
Jan 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hadar Hermoni Waldman, MDNPI 1568778124
Title
Owner
Phone
(310) 556-1427

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

10309 Santa Monica Blvd # 300
Los Angeles, CA 90025-5007

Mailing address

10309 Santa Monica Blvd # 300
Los Angeles, CA 90025-5007
Phone (310) 556-1427

Other identifiers 1

IdentifierTypeStateIssuer
2128906MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160226000220 CA Part B Supplier - Clinic/Group Practice 6709181928 Receives reassigned benefits from 2 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

10309 Santa Monica Blvd
#300
Los Angeles, CA 90025
Phone (310) 556-1427

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1346607280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10309 SANTA MONICA BLVD # 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255007",
            "telephone_number": "310-556-1427",
            "fax_number": "310-282-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10309 SANTA MONICA BLVD # 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255007",
            "telephone_number": "310-556-1427",
            "fax_number": "310-282-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HADAR H WALDMAN MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-22",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "WALDMAN",
        "authorized_official_first_name": "HADAR",
        "authorized_official_middle_name": "HERMONI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-556-1427",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2128906",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.